Failure to Provide Dietary Menus to Bedbound Residents
Penalty
Summary
The facility failed to ensure that two residents who were unable to get out of bed without staff assistance were provided with the daily dietary menu, resulting in these residents not being able to choose their food preferences. Observations and interviews revealed that neither resident had access to the menu in their rooms, and both reported not knowing what they would be served for meals until the food was brought to them. They also stated they were not informed about alternative food options and, in some cases, would not eat if they did not like the food provided. Resident 1 was totally dependent on staff for activities of daily living due to conditions such as intervertebral disc degeneration, diabetes mellitus, and sacroiliitis, but had no cognitive impairment and was able to make medical decisions. Resident 3 required substantial assistance with ADLs due to joint replacement surgery, unsteady gait, and generalized weakness, and also had the capacity to understand and make decisions. Both residents' physician orders specified particular dietary needs, but neither was given the opportunity to review or select meal options in advance. Staff interviews confirmed that menus were not provided in the residents' rooms and that some staff, including CNAs, were unaware of the daily menu. The dietary supervisor and LVN acknowledged that residents have the right to know their meal options and be informed of alternatives. The DON stated that menus were posted only in common areas, not in residents' rooms, and that residents who could not access these areas would only receive menu information if they asked. Facility policy required that residents be treated with respect and dignity and be assisted in exercising their rights, but this was not followed in the cases of these two residents.